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| For Donations to The Plumsted Township Republican Party Please print this page and fill out the form. |
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| First Name: | __________________________________________________ |
| Last Name: | __________________________________________________ |
| Address: | __________________________________________________ |
| __________________________________________________ | |
| City: | __________________________________________________ |
| State: | __________________________________________________ |
| Zip: | __________________________________________________ |
| Phone: | __________________________________________________ |
| Fax: | __________________________________________________ |
| E-Mail: | __________________________________________________ |
| Donation: | __________________________________________________ |
Please make checks payable to and mail to:
Plumsted Township Republican Club
P.O. Box 326
New Egypt, NJ 08533
For further information please call President Steve Reed 609-758-6211
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